Maternal mortality abortion services and stigma: Providers experiences and attitudes in Addis Ababa
Awarded 2011
Small Research Grants
Sarah Holcombe, MPH
University of California, Berkeley

Objectives: In 2005, Ethiopia enacted a rare reform, liberalizing its abortion law as part of the overhaul of the country’s Criminal Code. The reform’s aim was to reduce the country’s high levels of maternal mortality, which are due in part to unsafe abortion. This research explores the roles of Obstetrician-Gynecologists (Ob-Gyns) and the Ethiopian Society of Obstetricians & Gynecologists in the reform their motivations, strategies and alliances, as well as what they see as the causes of reform. Methods: Data from 51 in-depth interviews (10 with Ob-Gyns) conducted in 2012 in Addis Ababa, a purposive sample of leaders knowledgeable on reform, as well as government legal and programmatic documents and secondary research, were used. HyperResearch qualitative research software was used with a hybrid coding methodology, with codes based on initial predictions on actors and timing as well as codes emerging from the interview data. Preliminary Results and Conclusions: Ob-Gyns viewed reform as stemming from the country’s high maternal mortality due to unsafe abortion, the development of a body of research on unsafe abortion and maternal mortality, Ob-Gyn evidence-based advocacy efforts (and the preparation offered by experience with PAC), the growing public awareness of maternal mortality due to unsafe abortion, and coordinated advocacy of civil society along with receptiveness from government leadership. Other actors pointed to similar influences, but also emphasized the ruling party’s political commitment, and favorable features of the national policy structure and environment. Informants rejected the idea of external origins to this reform.